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Common variable immunodeficiency presenting with persistent parvovirus B19 infection.

Sarah T M Adams1, Kara M Schmidt, Karen M Cost

  • 1Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, Louisville, KY 40202, USA.

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PubMed
Summary
This summary is machine-generated.

Persistent parvovirus B19 infection can signal a humoral immune deficiency in children. Treatment with immune globulin intravenous may help resolve the infection and symptoms.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Parvovirus B19 infection is typically self-limiting in healthy individuals.
  • Persistent parvovirus B19 infection is observed in immunocompromised patients, particularly those with cellular immune defects.

Observation:

  • A 6-year-old boy presented with prolonged constitutional symptoms and polyarticular arthritis.
  • Laboratory tests revealed low immunoglobulin levels and impaired antibody responses, indicative of humoral immune deficiency.
  • Parvovirus B19 DNA was detected in the patient's plasma.

Findings:

  • The patient was diagnosed with common variable immunodeficiency.
  • Initiation of immune globulin intravenous therapy led to a significant decrease in parvovirus B19 DNA levels.
  • Constitutional symptoms improved, although arthritis persisted, and eosinophilic fasciitis later developed.

Implications:

  • Persistent parvovirus B19 infection can be an initial manifestation of humoral immune deficiency.
  • This presentation can be mistaken for juvenile rheumatoid arthritis.
  • Immune globulin intravenous therapy shows potential efficacy in managing persistent parvovirus B19 infection in immunocompromised individuals.